Abstract
BackgroundPatients with allergic rhinitis often trivialise their condition, self-manage inappropriately, and would benefit from health care intervention. The primary point of health care contact for these self-managing allergic rhinitis patients is the community pharmacy. With the majority of allergic rhinitis treatments being available for purchase over the counter, without health care professional contact, we know little about how the patients self-manage. This study aims to identify the burden of allergic rhinitis in the community pharmacy and to identify key opportunity for intervention.MethodsPharmacy customers, who purchased nasal treatment in a community pharmacy, were approached with a research-administered questionnaire that collected data on medical history, symptoms and products purchased for the treatment of nasal symptoms.ResultsOf the 296 participants, 69.9% self-managed with over-the-counter medications; with 68% experiencing allergic rhinitis symptoms and only 44.3% of this subgroup had a doctor’s diagnosis. Nasal congestion (73.6%) was most commonly experienced and oral antihistamines were most commonly purchased (44.3%), indicating a pattern of suboptimal management. A third of participants (36.5%) experienced moderate-severe symptoms, persistently, which impacted on their daily living. Medication selection was mainly based on pharmacy customers’ perceptions of medication effectiveness (47.6%).ConclusionA majority of participants that self-selected over-the-counter medications have symptoms consistent with allergic rhinitis, with almost half not having received a diagnosis. Medication purchasing patterns suggest that sub-optimal therapeutic decisions made by participants, even when they are experiencing significant symptoms. This study uncovers the hidden burden of allergic rhinitis in the community pharmacy and a missed opportunity to intervene and refer if necessary. Patients need to be guided through appropriate treatment as this study showed that many should be referred to a medical practitioner.
Highlights
Patients with allergic rhinitis often trivialise their condition, self-manage inappropriately, and would benefit from health care intervention
Others (14.2%, 42/296) included a combination of non-allergic rhinitis, sinusitis, postnasal drip and those who are unidentifiable (8.4%, 25/296) included a range of nasal symptoms for which a definitive cause of symptoms could not be determined without further referral to a medical practitioner
This study showed the feasibility of a pharmacist-implemented tool to identify the cause of nasal symptoms within a community pharmacy setting
Summary
Patients with allergic rhinitis often trivialise their condition, self-manage inappropriately, and would benefit from health care intervention. Differential diagnosis of AR from other forms of rhinitis is not defined as AR rarely presents in isolation [7] This complicates the management of AR [2] yet many sufferers are still self-selecting in the community pharmacy [8]. To optimise self-selection of AR medication, patients would ideally have received a diagnosis from a health care professional (HCP) and are able to determine the appropriateness of medication from the manufacturer’s written information [9]. In theory this may seem feasible, many with nasal symptoms do not seek diagnosis or advice [10]. Given that the management of AR is not straightforward, it requires proper medical guidance for self-management, in order to ensure that optimise treatment outcomes are achieved [1]
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